MEDICARE: REMEGIO M VILBAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician		IL

General Provider Information

NPI Number	:	1942259940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REMEGIO M VILBAR MD

Provider Business Mailing Address
First Line	:	1431 WESTERN AVE
Second Line	:	STE 202
City	:	CHICAGO
State	:	IL
Zip	:	60622
Country	:	US
Telephone Number	:	773-489-6605
Fax Number	:	630-585-6331

Provider Business Practice Location Address
First Line	:	1431 WESTERN AVE
Second Line	:	STE 202
City	:	CHICAGO
State	:	IL
Zip	:	60622-1727
Country	:	US
Telephone Number	:	773-489-6605
Fax Number	:	630-585-6331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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